| Name | Value |
|---|---|
| NAME | VA-*IHD LIPID PROFILE REPORTING |
| PRINT NAME | IHD Lipid Profile Reporting |
| CLASS | NATIONAL |
| SPONSOR | OFFICE OF QUALITY & PERFORMANCE |
| USAGE | RX |
| EDIT HISTORY |
|
| DESCRIPTION | Compliance reporting measures the LDL completed within 2 years as defined roll up LDL compliance totals for IHD patients. This reminder identifies patients with known IHD (i.e., a documented ICD-9 code for IHD in the last five years) who have not had a serum lipid panel/LDL (calculated or direct lab package LDL) or documented outside LDL within the last two years. If a more recent record of an UNCONFIRMED IHD DIAGNOSIS is found, the reminder will not be applicable to the patient. by the VA External Peer Review Program (EPRP) performance measure and the maximum guideline recommended below: The VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia recommends that patients with Ischemic Heart Disease have a lipid profile/LDL every one to two years; and that patients taking lipid lowering medications have a lipid profile/LDL at least every year. This national IHD Lipid Profile Reporting reminder is used monthly to |
| FINDINGS |
|
| FUNCTION FINDINGS | |
| TECHNICAL DESCRIPTION | This reminder is not for use in CPRS, hence there is no related reminder
No mapping necessary. Use the VA-ISCHEMIC HEART DISEASE
Rule 4: Anchor Visit
Find the subset of patients, after rule 3, with an Anchor
Visit 13-24 months prior to the beginning of the reporting period.
Use the same clinic codes used for the Qualifying Visit in Rule 2.
Rule 5: Associated Facility
The subset of patients resulting from the rules above are assigned
an associated facility that is used to accumulate national counts.
The Associated Facility for each patient is based on the following
criteria:
reminder taxonomy distributed with this term.
1) Use the primary care facility assigned to the patient
2) If more than one primary care facility is assigned or no
primary care facility is assigned, then find which facility has
the most visits on the local VistA system in the last two years
3) If the count of the number of visits is the same for multiple
facilities, use the facility associated with the most recent
visit between the tied facilities.
Reporting roll up will send totals for this reminder and facility for:
1) Reminder totals based on reminder evaluation:
applicable, not applicable, due, not due totals
2) Finding totals for most recent counts from the group of LDL
findings, based on Lab or Outside LDL findings:
LDL <100
LDL 100-119
LDL 120-129
LDL >129
OUTSIDE LDL <100
OUTSIDE LDL 100-119
OUTSIDE LDL 120-129
UNCONFIRMED IHD DIAGNOSIS
OUTSIDE LDL >129
The finding totals are based on reminder evaluation findings for
applicable patients using the reminder definition.
3) Finding totals for most recent counts from the group of IHD Diagnosis
and Unconfirmed IHD Diagnosis findings.
IHD DIAGNOSIS
UNCONFIRMED IHD DIAGNOSIS
4) Finding totals for most recent count of patients who have active
Lipid Lowering Agents within the reporting period.
Use the UNCONFIRMED IHD DIAGNOSIS health factor
CPRS vs. Reporting reminders: This VA-*IHD LIPID PROFILE REPORTING
reminder does not include orders placed, refused, or other defer
activities which clinicians use in CPRS to manage the VA-IHD LIPID
PROFILE clinical reminder. This Reporting reminder is restricted to Lab
results and Pharmacy medications found during the reminder evaluation
for each patient in the denominator patient list.
distributed with this term or add any local health
factor representing an unconfirmed or incorrect IHD
diagnosis.
LDL Enter the Laboratory Test names from the Lab Package
dialog.
for calculated LDL and direct LDL with "I +V>0" in the
CONDITION field.
The Lab tests defined in this term will be used to update
the following reminder terms findings:
LDL <100
LDL 100-119
LDL 120-129
LDL >129
For the following OUTSIDE LDL Reminder Terms, use the health factors
distributed with these reminder terms or add local health factors
or other findings to the appropriate reminder terms. The findings
should represent LDL values from a source outside the local facility.
OUTSIDE LDL <100
Distributed with health factor OUTSIDE LDL <100
OUTSIDE LDL 100-119
Distributed with health factor OUTSIDE LDL 100-119
OUTSIDE LDL 120-129
Setup issues before using this reminder:
Distributed with health factor OUTSIDE LDL 120-129
OUTSIDE LDL >129
Distributed with health factor OUTSIDE LDL <129
LIPID LOWERING MEDS
Enter the formulary drug names for investigation drugs.
Mapping non-investigative formulary drugs to the
VA-GENERIC drugs will ensure the lipid lowering
medications are found. The medications are informational
findings for this reminder.
National Roll-up:
The national reporting criteria for VA-IHD QUERI are defined in the
Reminder Extract Parameter file.
This national reminder is used by the VA-IHD QUERI Extract run monthly
to roll up compliance totals for LDL laboratory tests completed within
the past 2 years. The patients evaluated for compliance are based on VA
EPRP performance measure reporting criteria. The performance measure
1. Use the Reminder Term options to map local representations of
reporting criteria are used to create patient lists. The patient
lists used with this reminder are found in the Reminder Patient List
file with the following naming conventions:
VA-*IHD QUERI yyyy Mnn PTS WITH QUALIFY AND ANCHOR VISIT
VA-*IHD QUERI yyyy Mnn PTS WITH QUALIFY AND ANCHOR VISIT ON LLA MEDS
where yyyy is the calendar year, and nn is the month.
The patient lists are based on two different Extract Finding Rule Sets:
VA-*IHD QUERI PTS WITH QUALIFY AND ANCHOR VISIT
VA-*IHD QUERI PTS WITH QUALIFY AND ANCHOR VISIT ON LLA MEDS
findings:
The rule sets will find IHD patients of record within 5 years prior to
the beginning of the monthly reporting period who had a qualifying
clinic visit and an earlier (anchor) visit 13-24 months prior to the
reporting period. The patient list with ON LLA MEDS finds those patients
who have had a supply of Lipid Lowering Agent Medications in VistA during
the reporting period.
Rules for building the patient list for the reporting patient
denominator are:
Rule 1: IHD Patients
Start with Patients with an IHD 410.nn, 411.nn, 412.nn, or
414.nn diagnosis documented within 5 years prior to the beginning of
the reporting period.
Rule 2: Qualifying Visit
Find the subset of patients, from rule 1, who have a Qualifying
Visit during the one-month reporting period.
Qualifying Clinic Codes include:
Primary Care: 301 (General Internal Medicine), 322 (Women), 323
(Primary Care/Medicine), 350 (Geriatric), 531 and
IHD DIAGNOSIS
563 (Mental Health Primary Care)
Specialty Care: 303 (Cardiology), 305 (Endocrinology/ Metabolism),
306 (Diabetes), 309 (Hypertension), 312
(Pulmonary/Chest)
Include patients that had a Qualifying Visit during the reporting
period and subsequently died before or after the end of the
reporting period.
Rule 3: Exclude patients from the patient subset resulting from
Rule 2 that have a primary discharge diagnosis of 410.nn within 60
days prior to the Qualifying Visit.
|
| CUSTOMIZED COHORT LOGIC | FI(1)&FF(1) |
| INTERNAL PATIENT COHORT LOGIC | FI(1)&FF(1) |
| PATIENT COHORT FINDINGS COUNT | 2 |
| PATIENT COHORT FINDINGS LIST | 1;FF1 |
| INTERNAL RESOLUTION LOGIC | (0)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6) |
| RESOLUTION FINDINGS COUNT | 5 |
| RESOLUTION FINDINGS LIST | 2;3;4;5;6 |
| INFORMATION FINDINGS COUNT | 6 |
| INFORMATION FINDINGS LIST | 10;12;13;14;15;16 |
| WEB SITES |
|
| # OF GEN. COHORT FOUND LINES | 0 |
| # GEN. COHORT NOT FOUND LINES | 0 |
| # GEN. RES. FOUND LINES | 0 |
| # GEN. RES. NOT FOUND LINES | 0 |
| BASELINE AGE FINDINGS |
|
| # SUM. COHORT FOUND LINES | 0 |
| # SUM. COHORT NOT FOUND LINES | 0 |
| # SUM. RES. FOUND LINES | 0 |
| # SUM. RES. NOT FOUND LINES | 0 |